Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 101Y00000X | Counselor | 1549 | PR |
Y | 225C00000X | Rehabilitation Counselor | 1549 | PR |
NPI | 1043773799 |
---|---|
Provider Name | Mr. Carlos Eduardo Albarran SR. |
First Address | Bayamon, PR 00960-1991 |
Second Address | Bayamon, PR 00959 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 10/04/2019 |
Last Update Date | 10/04/2019 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
1549 | REHABILITATION COUNSELOR LICENSE (01) | PR |